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, <br /> ever=tt ' �� =`� - -- � � � <br /> � � ` , ' , <br /> City of Everett <br /> Engineering Department �'�� <br /> r <br /> Sewer Application and Permit �4 0 �1 <br /> N0. 2O9Z� DATE _, <br /> �`,� a_ , ,-: . ; . <br /> Service Address J �. ' � � - �' Utility Account No. <br /> Billing Address <br /> Connection Permit Fee <br /> City,State, Zip - <br /> Connection Fee <br /> Owner (Mortgagor) ' <br /> Total Fee <br /> Billing Name <br /> Connection By ` <br /> - ' _ Signed c„siom�. <br /> Address <br /> r <br /> Phone <br /> Sewer District <br /> DESCRIPTION: <br /> Lot Monthly Sewer Service <br /> Block._— <br /> Division or Addition Monthly Sewer Constr. <br /> Trunk <br /> Type PermiC Lateral <br /> Remarks: Abutting i_ot Line ft. <br /> N, S, E, W - <br /> A(JPfOVCC� BY_—�i��Enyinecr � <br /> Issued BY <br /> Inspection By �` �� � <br /> Datelnspected� <br /> 7 � <br /> � No. 20926 <br /> SEE SKETCH ATTACHED <br />